Chapter 9: Society, Trust and Safety

Nuclear is for Life. A Cultural Revolution 209

Chapter 9: Society, Trust and SafetyAh, this is obviously some strange usage of the word 'safe' that I wasn't previously aware of.

Douglas Adams, Arthur Dent in The Hitchhikers Guide to the Galaxy

Establishing public trustEarning trust and telling the truth 209Popular culture and the Precautionary Principle 211Innovation, leadership and confidence in science 213Communicating truth and confidence to others 214Recent leaders in the science of radiation 215Confidence to change an opinion 216Rights, duties and the survival of the fittest 218Losing trust by offering appeasement 219Money and safety – two social inventions of limited worth 221

Major health consequences of radiation accidentsCancer from Hiroshima and Nagasaki 222Inherited abnormalities caused by radiation 223Civil nuclear safety and radiological protection 224

Radiation doses As High As Relatively SafeAcute, chronic and lifelong thresholds of risk 225Radiation dose rates compared using a picture 228Largest lifelong dose that is safe 229Origin of currently recommended safety limits 229Conscious thought and adaptation 231Public attitudes towards nuclear technology 231

Notes on Chapter 9 233

Establishing public trustEarning trust and telling the truth

To the extent that people distrust one another, society fails and large populations become unstable; instability is a euphemism – in reality it brings a likelihood of war, famine and a dramatic fall in world population. Improvements in living standards need individuals to develop new ideas, and that requires imagination and creative intelligence shared with others. The

210 Chapter 9: Society, Trust and Safety

use of imagination alone too often brings apprehension of others and misunderstandings of the natural world. It creates fear of the unknown or ill health that needs to be challenged by evidence and study. In earlier centuries the public could be persuaded to support national policy through spectacular displays of military colour and fleets of ships decked with outsized flags. But with increased education the public take more persuasion. What they are told needs to foster trust in the authorities, but in times of war, to deceive the enemy, the whole truth is not told. To continue such deception is to live on borrowed time – sooner or later the truth will come out. In the meantime an increasingly tangled web of deception is woven. Hence the advice: Truth To Tell: Tell It Early, Tell It All, Tell It Yourself. [1]Since World War II the matter of ionising radiation safety has become further and further removed from objective truth. In 1934, the year that Marie Curie died, radiation protection recommendations were based on avoiding burns, called tissue reactions, and the longer term effects known from the discovery of bone cancers among the Radium Dial Painters in 1926. The recommendations were based on a damage threshold set at 0.2 Roentgens per day; in modern units that is 640 mGy per year of gamma rays. In 1951 the safety threshold recommended by the International Commission for Radiological Protection (ICRP) was lowered to 0.3 Roentgens per week, which is 140 mGy per year. In 1955 the ICRP recommended that the use of a damage threshold be discontinued and that the LNT model be used to assess proportional risk all the way to zero dose. From high dose data it was judged that the slope of the LNT straight line corresponded to an increased mortality risk of 5% for each 1,000 mGy of whole-body dose (assumed to be gamma rays or other low LET radiation) [2]. The vital question is why this change was made.Two reasons are apparent:

• epidemiological evidence of excess cancer malignancies among radiologists, and also among industrial and defence workers;

• indications of excess leukaemia cases in the survivors of the atomic bombings at Hiroshima and Nagasaki, whose probability of occurrence, not the severity, was assumed to be proportional to the size of the dose.

Today neither of these reasons look tenable. As discussed in Radiation and Reason [see Selected References on page 279, SR3], the dominant effect amongst groups of radiation workers and ex-workers below the age of 85 is that they have a mortality which is consistently 15-20% lower than other comparable groups [3]. This is true in different countries. Whether there is an undetected selection effect, the so-called Healthy Worker Effect (HWE), or a


hormetic effect, cannot be determined from these data. However, claims for small increases in cancer rates of a few percent depending on lifelong accumulated dose have been made [3]. The doses involved are no larger than background variations that show no such effect; the claims are of questionable statistical significance; they cannot be taken seriously while the much larger HWE remains unexplained and uncontrolled.The incidence of leukaemia at Hiroshima and Nagasaki was also discussed in Radiation and Reason, [SR3]. Among 86,955 survivors there were 296 cases between 1950 and 2000, while data on those not irradiated suggest that there would have been 203 cases in the absence of radiation. There was no evidence of radiation-induced cases for doses below 200 mSv.But starting in the 1950s there were other forces that began to influence cultural attitudes to radiation, and Chapter 10 follows how these distorted the views of both scientists and politicians from that time.

Popular culture and the Precautionary PrincipleGeneral education has provided little appreciation of ionising radiation and nuclear technology. Few people go out of their way to study or attend public lectures on the subject out of interest. Most prefer to avoid matters that they think promise no excitement or stimulation. They are content that practical matters are handled by consulting expert opinion, although that does not build a sense of trust in the way that personal knowledge and experience would. Dismissing this ignorance as a consequence of globalisation is no solution. A few decades ago, most people could tinker with their car, and, if it ceased to work, get it going again – but not today. Globalisation has removed individual responsibility for many aspects of life, but some matters like the effect of nuclear energy need to be talked through holistically – and this is harder if the technology is obscure to almost everybody. People should have direct or indirect contact with someone who understands and can answer questions. That is essential to social cohesion and the stability of public opinion.Popular opinion is impressed by what science achieves. People notice that science frequently consolidates its findings into principles or laws, and these are accepted as analogous to legal laws. Then any conclusion drawn from a generalisation that has been blessed with the title of principle or law assumes an extra legitimacy in the public mind and is seen to need no further questioning. One may think of the popular Law of Averages or the Law of Unintended Consequences, neither of which deserves such lofty status. Exactly how such a title is conferred is unclear – but its indiscriminate use is not scientific. A significant example is the Precautionary Principle that appeared in the 1980s


and has been used intensively in the safety industry ever since, frequently with the effect of obstructing innovation or buttressing restrictive practices. The pre prefix added to caution, the regular common sense word, implies a sensible policy of additional safety during the introduction of a new technology, for which measurement and monitoring procedures are primitive and understanding is still uncertain. However, application of this idea incurs extra costs and is time consuming; it leads directly to lower productivity and uncompetitive practices in industrial applications; as soon as understanding and information allow, it should be superseded. Its application to nuclear technology with its advanced measuring and monitoring instrumentation, and a century of understanding, has long been entirely inappropriate. It is being used as a cover for public fear and to disguise the ignorance of those supporting it. The public believe that understanding radiation is beyond them, but for safety at least, that is incorrect. Although they have never been told the real story of nuclear radiation in accessible every-day terms, it is high time that they were – at school, in public lectures and in the media. Future prospects for world economic prosperity and a sustainable environment depend critically on explanatory education and improved public trust in science. This is essential if the known benefits of nuclear technology – power, clean water, food preservation, advances in healthcare – are to be widely accepted and realised. These are needed if man is to survive on planet Earth in large numbers with good health and a fair standard of living. Dangers from choice of lifestyle are often discounted relative to those seen to be caused by the irresponsibility of others. Significant external threats to family life may centre on economic stability and social competitiveness, but worries that impact individuals, such as cancer and death, though far more threatening, are personal and do not contribute to collective fear and panic. In crowds overreaction can be reduced if enough individuals show leadership, but others need to trust them. Otherwise, rumour, amplified by uninformed imagination and repetition in personal and public media, becomes unstable with the result that public confidence implodes and the mutual trust that is essential to an effective society is seriously damaged. A similar example is public attitudes to genetically modified (GM) crops, particularly in Europe. Reporting on nanotechnology has had some ill-informed moments too. As population density increases, the necessity of mutual understanding increases too, and there is no question of going back to the way things once were. More than ever before, it is essential that trains run on time, utilities are delivered reliably, vehicle drivers are trained and disciplined and telephone and internet services are up and running. For the future there is the need to find new opportunities for economic expansion which put yet more emphasis


on education and building confidence in the applications of scientific understanding. In the past two centuries such opportunities have come from applications of engineering and medicine, based largely on exploiting the outer (or electronic) part of atoms – that is chemistry, electrical power, electronics, lasers and the science of materials. But the inner (or nuclear) part of atoms has only been exploited for health in the footsteps of Marie Curie a century ago. The use of radiation and nuclear technology in other contexts has been largely avoided, primarily because of the phobia felt by public and political authorities. In an era that includes climate change that is a restriction we can no longer afford.

Innovation, leadership and confidence in scienceScience is for participants, not spectators. It should be experienced personally in the real world through study, experiment, prediction and imagination. Everybody on Earth is involved to an extent, and denying this reduces the possible scope of life. Such active experience of science has lifted man above the plants and animals and made him master of his destiny by understanding how to solve the problems that threaten survival, not just at the level of tribe or group but at the individual level too. Rules, customs, laws and habits which ensure the continued existence of a group are cumbersome and apt to change slowly – as anyone who has served on a committee is aware. An individual who is able to deploy rational thought and apply it scientifically to overcome the challenges he encounters, improves the life-chances for all in the group through to an ability to change rapidly and innovate that is excluded by the inertia of committee-land. If everybody followed the guidance of the official consensus, many advances in the history of mankind would not have occurred. So a balance is needed between innovation and obedience to authority. How has this balance worked for the wider good in the past? Who successfully combined innovation with authority?Science is not alone in searching for such figureheads. Think of the banks – the issuers of bank notes denominated in the local currency – they are concerned to impart as much gravitas and respectability as they can muster for their notes, new and used. Whom do they select? Past monarchs and other heads of state, especially those with reputations immutably assured by history, but also great scientists and thinkers. In Illustration 6 on page 8 are four such figures, two men and two women: some have much to say about the science with which we are concerned; the others have authority and wisdom that is no less relevant.It was the breadth of their lives, as well as their incisive technical ideas, that


was the key to their success. Certainly none set out as an expert in their field, since that did not exist prior to their contribution, and some of them would have been obstructed from carrying out their work by modern regulations. Many of their applications for research grants would have been rejected by the peer review mechanism and, in fact, they had to overcome substantial obstacles to get their ideas established. Adam Smith (1723-1790), economist and philosopher, has appeared on the Bank of England twenty-pound note since 2007. He is said to have disliked Oxford and committees, and he lived in Scotland.Charles Darwin (1809-1882), naturalist, biologist, geologist, and student of divinity, has appeared on the Bank of England ten-pound note since 2000. He had a remarkable eye for geology which seems to have inspired his view of the evolution of life, a synthesis in tune with the writings of the environmentalist, James Lovelock, today – or the other way around, perhaps. Florence Nightingale (1820-1910), nurse and statistician, appeared on the Bank of England ten-pound note from 1975 to 1994. She wrote

How very little can be done under the spirit of fear.Marie Curie (1867-1934), physicist, chemist and pioneer radiologist, was born Marie Sklodowska in Poland. Her portrait appeared on the Polish 20,000 zloty note in 1989 and then on the French 500 franc note in 1998.

Communicating truth and confidence to othersThinkers like Adam Smith and Charles Darwin achieved new goals by concentrating on fresh data interpreted with common sense and imagination. Florence Nightingale is generally remembered for her pioneering work in nursing at the time of the Crimean War in 1855. However, the method that she used to promote nursing was quite revolutionary. Prior to her work, political and military authorities had concentrated their attention on the supply of fresh troops and munitions for the battle front and paid little heed to the fate of the wounded. In her work she collected data on mortality rates among casualties and analysed them to show how much more effective the war effort would be if greater care were taken to nurse wounded soldiers. To do this she used new graphical techniques to bring life to her data and arguments when trying to make her point to those less gifted in numeracy. She herself, being a distinguished early statistician, ensured that lay people and politicians understood the implications of the data. An example of her use of coloured charts is shown in Illustration 35. Her method and success provide us with an important example because we try to follow the example of her graphics when trying to bring to life the safety of radiation (Illustration 2 on page 4) and when talking of waste (Illustration 9 on page 10).


Recent leaders in the science of radiationThe mission to set the record straight on the relative safety of ionising radiation is not new. A number of distinguished scientists, oncologists and engineers who died in recent years made major contributions during their lives to the public understanding of the effect of low doses of radiation:

Maurice Tubiana (1920-2013), a French medical physicist and oncologist. A leading author of the highly significant 2004 French National Academies report [4], Tubiana championed the safety of nuclear power and wrote the book Arretons d'avoir peur! [Stop being frightened!] He was given a military funeral in the Hotel des Invalides in Paris.Zbigniew Jaworowski (1927-2011), a Polish physician and chairman of UNSCEAR (1981-2). Theodore Rockwell (1922-2013), a nuclear engineer, particularly in submarine propulsion. A tireless campaigner for facts in support of nuclear power.Myron Pollycove MD (1921-2013), a radiobiologist whose clinical work and writings contributed to our understanding of the effect of low-dose radiation.


Don Luckey (1919-2014), a biochemist who surprised the world in 1982 with the message that low-level radiation is good for health and followed it with the first Symposium on Radiation Hormesis in 1985.Bernard LH Cohen (1924-2012), a physicist who staunchly opposed the LNT model and wrote six books on nuclear physics and nuclear power.Lauriston Taylor (1902-2004), a physicist. Charter member of ICRP 1928. Founder and chairman for 48 years of NCRP. In a 1980 lecture [5] he made several statements that are still relevant today:

Today [1980] we know about all we need to know for adequate protection against ionizing radiation. Therefore, I find myself charged to ask: why is there a radiation problem and where does it lie?

No one has been identifiably injured by radiation while working within the first numerical standards (0.2 roentgen/day) set by the NCRP and then the ICRP in 1934.

An equally mischievous use of the numbers game is that of calculating the number of people who will die as a result of having been subjected to diagnostic X-ray procedures. An example of such calculations are those based on a literal application of the linear non-threshold dose-effect relationship, treating the concept as a fact rather than a theory. ... These are deeply immoral uses of our scientific knowledge.

Confidence to change an opinionWhat is really necessary is to persuade the public that radiation is more or less harmless at a level that anyone is ever likely to encounter – so they should be content to embrace it. The public has a pre-existing view – they believe that they already know that radiation is dangerous. The words of Tolstoy quoted in Chapter 2 are worth repeating here:

The most difficult subjects can be explained to the most slow witted man if he has not formed any idea of them already; but the simplest thing cannot be made clear to the most intelligent man if he is firmly persuaded that he knows already, without a shadow of doubt, what is laid before him.

So the message that tells them that radiation is not dangerous is ignored or treated as unwelcome. Telling people that they have no need to worry is seldom effective.

However, there is an important group of people who have completely changed their minds. That is very difficult to do, especially for those who


have been publicly active in their opposition to nuclear technology. Five of them – Stewart Brand, Mark Lynas, Gwyneth Cravens, Richard Rhodes and Michael Schellenberger – have made a documentary, Pandora's Promise [SR6], directed by Robert Stone, in which they explain why they now support nuclear energy. More important than the outstanding reviews that it has received is the example that the film gives of people, not scientists, who have looked at the evidence and stood up for what they now believe. There are others too; a new website offering nuclear generated electricity in Germany [6] went live in December 2014 with the support of former activists, founder members of Greenpeace and other environmentalists, including Patrick Moore, Stephen Tindale, James Lovelock and Stewart Brand.

But most people have busy lives, so difficult and confusing questions, such as whether to use nuclear energy, have to take second place to matters of money, children and employment. And the specialists around the world have their professional standing and reputations to worry about, too. They are anxious to be seen to support their own consensus and do not want to appear to change tack – unless everybody else does too. So they have a considerable inertia.

And the political authorities? Well, they have to face up to difficult questions and ensure that they have the electorate behind them when they do, because woe betide them if the lights go out on their watch. So what are they to do? They must synchronise any change of opinion:

• They need to try to appreciate the balance of the discussion themselves.

• They need to get the backing of the international experts – they can hardly hold out against those who are sanctioned by the UN.

• They need to get the objective facts properly covered for the benefit of schools, colleges and evening classes – and the teachers who cover these.

• They must ensure that the necessary changes in policy are accepted and supported by a majority of the public.

How such a change should be managed was described in an invited talk at the 1992 World Economic Forum, Davos, by E Schein of MIT School of Management [7]. To introduce a real change of paradigm, as needed here, the existing order has to be seen as increasingly threatening and the new order has to be introduced in a positive and rewarding light. The current world order based on the combustion of carbon (hitherto seen as comfortable and welcoming) needs to be re-presented in its threatening colours of imminent and unavoidable climate change. The new order has to reconfirm the headline that with reworked regulations nuclear-generated electricity should indeed be almost too cheap to meter. This raises an interesting question: which


commodities should not be too cheap to meter? We might suggest that water should replace electricity as a suitable utility to be more universally and aggressively metered – but that is another issue.

Using reason to change minds requires hard work and discipline. Evidently the senior environmentalists who have adopted a new view have been able to do this, but most members of the community at large have not. There is an interesting parallel in the therapy treatment of stroke patients that requires similar application. Following an attack, functional MR images show how the existing mental functions of the damaged region of the brain have to be transferred to a different, but undamaged, healthy region. This then needs to be programmed for its new role, and the patient has to work very hard at mental and physical exercises, with the help of therapists, for this to happen successfully. It would seem that embarking on a complete change of opinion on an emotive subject such as nuclear energy is a similar process. It is not just a matter of transferring knowledge – it has to be assimilated and accepted. Making such a transition successfully may be eased by varying the medium in which the case is made. Humour, music, plays, novels, video and poetry could contribute towards establishing a change of culture. In the days of the Cold War an important impression made this way helped to influence a couple of generations of young people, who marched and demonstrated against everything that nuclear energy stood for. To replace that fear and mass dread with a cultural rehabilitation of radiation and a whole new attitude to nuclear technology, will require a new culture that appeals to the identity of another generation – although their loyalty will, hopefully, still be to the environment and world peace, like their grandparents 50 years before.But time is important. Humans may have a long lifespan, but in 50 years much experience gets lost. Basic knowledge may be recorded, but more subtle skills and the confidence that goes with using them are easily lost. The experience of building railways in the UK, like the skills of ancient Greece and Rome, were all but lost in a few generations. Much of the practical experience of building nuclear power plants has already been lost and must be imported – an expensive thing to do. The rebirth of a nuclear age should not be long delayed, and educational programmes should aim to transplant still-living experience into fresh minds before it is lost.

Rights, duties and the survival of the fittestThe survival of the fittest, the rough melee of evolutionary biology, makes no reference to rights. Rights are additions that we have to give up occasionally to survive, and safety is one of them. Indeed there is a tradition of honouring those who do put aside their own safety for the sake of others on the battlefields of war.


But not every such choice is faced on a battlefield. There are other much more prosaic situations where there is a duty to step out of line and expose personal judgement in front of others. That may require a similar mix of bravery and self-confidence to that needed to enter no man's land and rescue a fellow soldier under fire. Here is an example with a stark message. Over many decades the infamous personality, Jimmy Savile, inveigled himself into many people's confidence in UK hospitals and outside in the wider community, and then sexually abused patients, staff and visitors, while enjoying special open access at all times. Many suffered, many more knew, but nobody spoke out sufficiently to question the authorities who claimed they knew nothing about it. Nobody was prepared to put aside their own psychological safety to save others. Duty? Hans Christian Andersen's tale, The Emperor's New Clothes, is told to children who find it very funny, but also appreciate its seriousness. The vain emperor and his entourage of sycophantic courtiers stick to the official line that he is wearing a magnificent new suit of clothes, when in fact he is wearing nothing at all. Nobody dares to say what all can see – except a small boy from the street who shouts out the truth. The story is a harmless rendition of the Jimmy Savile story – but nobody spoke out in the Savile case! There was silence, and many innocent people suffered for many years in consequence.Duty includes saying it how it is when everybody else appears ready to deny it. Doing so may risk unpopularity and isolation, but what is obvious should not be denied. If on re-examination and re-testing no flaw comes to light, it remains undeniable. It is interesting to read Charles Darwin's thoughts about many of the geological rocks and fossils he found in his journey round South America in HMS Beagle in the 1830s [8]. It was obvious to him that these were immensely old, having started below sea level and been pushed up, heated, weathered and broken. To him the Earth was not just old, but very much alive, and the biblical account of the Earth, as young and dead, was entirely mistaken.

Losing trust by offering appeasementEqually mistaken is the account of risks to life from ionising radiation, described by the LNT model and adopted by the current safety regulations: these imply that all radiation doses be kept as low as possible (ALARA), the basis for safety legislation around the world. Attempting to build public trust by appeasing worries about safety on this basis makes several assumptions that are untrue or damaging to society:

• It assumes that ionising radiation and radioactivity are extremely hazardous to life. As we have seen that is not the case and we have


the evidence and explanations to hand.• It assumes that society at large is too stupid and ill educated to

understand the simple scientific situation. This is a denial of democracy and a council of despair – or a case for maintaining a scientific under-class, forever stupid and uninformed, while matters are overseen by a hegemony of safety experts. We must hope that young people will demand to be educated and have the truth explained – hopefully some of them are reading this book.

• It assumes that the general public has no experience of significant radiation doses, let alone the very high doses received beneficially in therapy and the much more moderate doses in scans. Society would benefit from a more open explanation of such treatment by the medical profession.

• The current safety regime assumes that the accident at Fukushima indicated a need for greater safety in the design and operation of nuclear plants. This is untrue. The claim suggests appeasing the media clamour for further safety, which is a waste of resources. New designs should be developed, and should be selected in due course on economic as well as safety grounds. They should burn the existing stockpile of partially used fuel, and be able to burn thorium fuel too, but safety should not be the single priority – it certainly is not in the carbon fuel industries. Most existing reactor designs were seen as acceptably safe before the Fukushima accident, and should be seen as equally safe now.

There are vested interests who have reason not to support any liberalisation of nuclear energy and a reduction in radiophobia: those in the media who have preached against it and taken a stand for many years; those in the safety industry for whom the status quo offers stability of career and reputation; others with long-term commitments to pressure groups, such as Greenpeace. There are more who have thrown in their lot, investment or career, based implicitly on ALARA. Few of these would welcome change, but the young people of tomorrow whose future is at stake have no such baggage.If the public feel that they can trust neither the science nor the authorities, confidence is eroded and few people feel able to exercise their own judgement. Democracy only works when voters study the actual evidence, not just what others say about it. The voice of science itself is not democratic – that is, its truth is not influenced by any kind of vote. Nor indeed does it bow to authority or any court of law. Nature is the popular face of science, and independent of any green agenda, nature will do what science determines – and intelligent authorities know that. Illustration 7 on page 8 may bring a smile. It tells the story of King Canute, a


wise Scandinavian and English king who reigned a thousand years ago. He was pestered by his courtiers who thought only of winning his favour, and that anything he commanded would be done. To show them this was not true, he ordered his throne to be taken to the water's edge on the beach as the tide was coming in. Then he commanded the tide to go out, but his sycophantic followers were surprised to see the tide disobeyed and the water continued to rise, lapping around the king and his throne. Man cannot stop nature, and there is no design of nuclear power station that cannot be overwhelmed, if not in one way, then in another. It is nobody's fault that accidents like that at Fukushima Daiichi happen. Nature has the last word, as King Canute himself understood.There is no tradition that scientists take an Oath of Duty, but perhaps there should be. Physicians traditionally take the Hippocratic Oath to place the health and safety of their patients first. In a similar vein, research scientists should implicitly agree to put truth about nature in first place. Then they might appreciate how nature provides better protection than reliance on regulation. Law, obediently followed and backed by the possibility of redress, is no substitute for active and knowledgeable accident prevention in the first place. A similar observation is that taking out insurance is inferior to good care, and that a successful insurance claim never returns what has actually been lost.

Money and safety – two social inventions of limited worth

Insurance and legal redress come down to money. Like money, safety is a social rather than a physical measure: both relate to contracts involving trust and confidence within society, but both are flawed. Money is not itself beneficial – that only happens when it is given away in exchange for something desirable. All money must be surrendered at death anyway. Similarly, all safety provisions must fail in the end, since death is a given for us all.At best, money and safety provide choices. The value of money is flexibility in the range of goods for which it can be exchanged. But if many people hoard it or nobody wants it, it enables no contracts and ceases to have any dynamic value for society. Any such reduction of contracts puts a sharp brake on social and economic activity of all kinds. An obsession with safety has a similar effect by reducing human activity or squandering it on unproductive investment. For example, to be safe and avoid the many small risks of the day, to save money even, you might decide to stay in bed, thereby cutting productivity and contributing to a decline in the economy. Safety comes at a price.But, if instead of a risk-averse attitude towards safety, the population at large


is more inclined to take a calculated gamble, ideally by examining the science and reckoning the chance of success or failure, the economy would be stimulated. The social cost of an occasional failure would be more than balanced by the economic uplift. So, today, how far are we from some sensible compromise or equilibrium? Attitudes to money are poor, but perhaps not completely distorted. However, the view of nuclear safety is so totally unbalanced that to some groups in society, any risk at all is unacceptable, while no one else dares offend this extreme sensitivity. The politics of this situation is stabilised by scientific ignorance, but the economic consequences are dire and will continue to be so. When combined with the growing use of carbon fuels, the environmental consequences are seen to threaten the existence of human civilisation and other forms of life.The way in which we use safety today is equivalent to a policy of financial liquidity in which we are so frightened that we hand all our money to the government for safe keeping. Such a regime would have no liquidity at all, no risk takers and no prospect of prosperity. That is not hard to see.

Major health consequences of radiation accidentsCancer from Hiroshima and Nagasaki

There would be no particular excuse for anybody to be frightened of radiation if WWII had not ended with two nuclear bombs being dropped on the cities of Hiroshima and Nagasaki in August 1945. The principal effects of a nuclear weapon are a blast, a fireball and a prompt pulse of radiation. At Hiroshima and Nagasaki these killed at least a quarter of the population of 429,000. In 1950 when reliable records were compiled, only 283,000 survivors could be traced, and their medical health has been followed ever since [9]. Knowing where the bomb detonated, where the individual was and what material there was to shield them from the radiation, enabled individual radiation doses to be calculated for 86,955 of these survivors. These doses were checked against the personal radiation history of individual survivors as recorded by chromosome abnormalities and unpaired electron densities (ESR) in their teeth. The average whole body dose of survivors was 160 mGy from the acute X-ray and neutron fluxes. Most of those who died within days were killed by the blast and the fire, but some succumbed to Acute Radiation Syndrome in a few weeks. Although a few died of cancer before 1950 the majority of such cases would be expected later, in the period 1950-2000 for which data are available. Similar data for inhabitants who lived beyond the reach of the radiation have also been analysed for comparison. This is important because the normal cancer mortality rate in the absence of an artificial radiation dose is not small, and any comparison should be made


with groups of inhabitants who are otherwise the same.Of those survivors with a reconstructed dose, 10,127 died of solid cancers between 1950 and 2000, compared to 9,647 expected based on data for those not irradiated; for leukaemia the numbers are 296 and 203. Together these numbers mean that 93% of cancers would have happened anyway and 7% were caused by the radiation. For the 67,794 survivors with doses less than 100 mGy, the numbers are 7,657 and 7,595, and for leukaemia 161 and 157. For this group of survivors the numbers of extra deaths (62 solid cancers and 4 leukaemia) are smaller than the standard random errors calculated by Poisson statistics (90 and 13), and so are not significant measurements. But in this group of 67,794 people the risk is only about 1 in 1,000, anyway. For comparison, the lifetime chance of dying in a road accident varies between 3 and 6 in 1,000. So, for all practical purposes there is a threshold of risk from a dose of acute radiation at about 100 mGy. What happens at lower doses is too small to measure – even among the survivors from the bombing of two major cities whose health is followed for 50 years. Perhaps it is best summed up this way:

Suppose you were unlucky enough to be in Hiroshima or Nagasaki when the bombs were dropped, and you survived until 1950. If you received less than 100 mGy (like 78% of the other survivors), then the chance that you died of cancer between 1950 and 2000 from the radiation would be less than 20% of the chance of dying from a traffic accident in the same period of time.

The dose at Hiroshima and Nagasaki was an acute radiation pulse with little protracted or chronic contribution from residual radioactivity. This is the worst case – the same total radiation dose suffered as a chronic dose due to radioactivity spread over days, months or years would be substantially less dangerous, thanks to biological repair, replacement and adaptation.

Inherited abnormalities caused by radiationBut cancer is not the only worry that people have had about radiation since 1945. Having learned that radiation has the power to modify DNA, there has been concern that radiation might modify the design of human life itself, as inherited by each generation and passed down to later ones. It is clearly possible, but does it happen? At the time of the Cold War, imagining the implications of this possibility increased the nuclear threat – and was, therefore, an effective political weapon. It fuelled decades of horror fiction – stories of two headed monsters, and pets with extra legs, made exciting entertainment and stimulated the imagination. Unfortunately it took a few years before the scientific consensus emerged that there is no such evidence, based on the survivors of Hiroshima and Nagasaki, on data from Chernobyl, or any other source. It does not happen, in humans anyway, but in the 1950s


and 1960s before this conclusion was reached, asking the question had major consequences, as we report here in Chapter 10. But in 2007 the ICRP cautiously reduced their risk coefficient for inherited damage to some 20 to 40 times smaller than that for cancers [10]. That inherited genetic damage has never been seen in higher life forms is thanks to the immune system, but that does not mean it can never occur. In principle, any of us could be hit on the head by a meteorite tomorrow, but that is not going to happen either.

Civil nuclear safety and radiological protectionIn the context of a nuclear power plant and far away from the blast and fire caused by the explosion of a nuclear weapon, the idea of safety covers two quite separate concerns: the control of the reactor and the protection of people, the latter usually described as radiological protection. Shutting down a reactor by absorbing all free neutrons stops all further nuclear fission, but leaves unquenched the 7% of its power output that comes from radioactive decay, the decay heat. At Fukushima the consequences of being unable to remove this decay heat resulted in the destruction of several reactors. Stabilising the operation of a reactor and providing cooling to remove the decay heat are important and expensive engineering tasks. At Fukushima Daiichi they were overwhelmed by exceptional conditions beyond the design specification of the reactors. The result was an accident of the kind usually labelled an Act of God in discussion of insurance risk. Put another way, there is no human design that cannot be overwhelmed by nature. Nobody was to blame for this and, furthermore, nobody was hurt, not even those who worked at the plant under very difficult circumstances and took important decisions, such as to release the excessive reactor pressures. For that they deserve praise and thanks.But we can ask,

Among the workers at Fukushima how many deaths due to radiation might there be as a result of the accident in the next fifty years?

Thirty workers are reported to have received doses as high as 100-250 mGy, but the lowest dose suffered by any worker at Chernobyl who died of ARS was 2,000 mGy – and they died within three or four weeks. So it is not surprising that no death from ARS has been reported at Fukushima, and none will be in the future. What about cancer in years to come? Of the 5,949 survivors of Hiroshima and Nagasaki who received doses in this range (100-250 mGy), 732 died of solid cancer (and 14 of leukaemia) against expected numbers of 691 (and 15) in the absence of radiation (calculated from those there but not irradiated). The difference, 40, is a measure of the number of cancer deaths caused by radiation – as a proportion, it is one person in 150. At Fukushima there were just 30 workers who received a dose in this range, and 1 in 150 of those is 0.2. That is less than one person on average, meaning


that it is unlikely that any worker at Fukushima will die of cancer from radiation, even in the next 50 years. The public have received far lower doses than the workers and are in no danger from radiation-induced cancer whatever.The evacuation criterion and public exposure limit at Fukushima were based on 20 mGy per year, but there was great public pressure to lower the figure to 1 mGy per year. Such a limit could only be interpreted as additional to natural levels that show large variations anyway with soil type, altitude and latitude. Even 20 mGy per year as a chronic dose is 10,000 times lower than the monthly dose to healthy organs accepted by radiotherapy patients in Japan – and standards of medical care in Japan are among the highest in the world, as confirmed by life expectancy figures. The dose rate of 20 mGy per year is 60 times lower than the conservative safety threshold of 100 mGy per month suggested later in this chapter. Unfortunately the evacuation and clean-up regime imposed at Fukushima has had serious socio-economic consequences for the inhabitants of the whole region, without benefit of any kind, and was a tragic mistake. To this should be added the major economic and environmental cost of failing to restart the existing nuclear power plants and the related importation of fossil fuel.The accident at Chernobyl was more than 25 years ago and questions about safety have been answered – what happened, who suffered and how, has been extensively reported in publications by the World Health Organisation, the United Nations and the International Atomic Energy Authority. The known loss of life as a result of radiation exposure includes the 28 firefighters who died of ARS and 15 children who died from thyroid cancer. These reports conclude that there is no firm evidence for any other loss of life due to radiation, either individually identified or statistically shown. The higher numbers sometimes quoted are paper calculations that use LNT-based risk coefficients (such as 5% risk of death per Gy) combined with measurements of Collective Dose. If the low doses of a large number of people received over many years are all added up, the result is a Collective Dose. This is without meaning except in the LNT model. Since 2007, even the ICRP, that still champions LNT, has cautioned that such calculations should be avoided.

Radiation doses As High As Relatively SafeAcute, chronic and lifelong thresholds of risk

Suppose that you are building a bridge. Everybody agrees that it should be cost-effective and safe. But how safe? You would not advertise the bridge weight limit as the lowest that you might imagine by using the argument that the lower the weight limit applied the safer is the bridge in use. By lowering


the weight limit you might incur greater risks by sending heavier trucks on a long diversion route. Rather, safety thresholds should be set As High As Relatively Safe (AHARS) – conservative but mindful of other risks, which is where the relatively comes in. No extraordinary case should be made for radiation – the record shows that there are other aspects of life that are considerably more hazardous, and the risks and safety of radiation should be reckoned alongside other considerations. Nuclear is not a special risk and in fact is rather safe.Following the discussion in Chapter 8, a sensible safety regime, conservative and based on modern radiobiology, might place safety thresholds on:

1. a maximum single acute dose;2. a maximum chronic dose rate averaged in any month;3. a maximum lifelong accumulated dose to limit damage, if any, that

never gets repaired and escapes monitoring by the immune system.The value of these high limits should be a matter for discussion based on conservatively interpreted scientific data. If people want to impose tighter limits in their own lives or in the care of their own families, they should be free to do so. What they should not be permitted to do is restrict the lives of others because of their own angst or that of a their chosen pressure group.In 1951 the dose-rate safety level was set at 3 mGy per week (12 mGy per month, 150 mGy per year). Although the civil nuclear radiation safety record has remained exceptionally good since 1951, for no identifiable scientific reason the maximum dose recommended for the general public has been reduced by a factor 150, in pursuit of ALARA, whereas in the light of current knowledge of the effect of radiation on human life, the 1951 recommended value might reasonably have been increased by a factor of about eight. That would set the limit back close to 700 mGy per year, the value set by ICRP in 1934, before the era of angst and distrust began.Now, 70 years after Hiroshima and Nagasaki, what should we say of the safety of radiation? It certainly can be deadly at high dose, especially if given to the same living tissue in a short period. An acute whole-body dose of 5,000 mGy, given all at once, has the same fatal effect on cells as more than 10 times that dose, spread out over six weeks in a course of radiotherapy treatment. Wherever the line is drawn between what is safe and what is not, the safety mechanism should be understood. There should be evidence to confirm the threshold of damage, and the public should have confidence in how this is determined. The most simply justifiable safe limit is the highest that can be shown to cause no harm. To put it higher would not be conservative and


Illustration 2, A diagram showing monthly radiation dose rates represented by the area of circles.

• Red circle, 40,000 mGy per month, less than a radiotherapy dose rate that kills a tumour;

• Yellow circle 20,000 mGy per month, a dose rate that healthy tissue near a treated tumour receives and usually survives;

• Green circle 100 mGy per month, a benign and conservatively safe dose rate, As High As Relatively Safe, AHARS;

• Small black dot 0.08 mGy per month (1 mGy per yr), an unreasonably cautious rate, As Low As Reasonably Achievable, ALARA. (Also shown expanded for greater visibility.)


responsible. If it is put much lower the stricter regulations incur extra costs without any known benefit. Worse, when the public do receive a dose rate that is above the regulation level but below that which is harmful, there will be upset, claims for compensation, even panic, without reason. To set a safety limit As Low As Reasonably Achievable (ALARA) in a misguided attempt to appease public radio-phobia, is to invite public unrest, mistrust and misery, as happened at Chernobyl and Fukushima – as well as precipitating unjustifiable added costs and environmental impact.

Radiation dose rates compared using a pictureWe may wonder what diagram Florence Nightingale might have drawn at this point to make the relative sizes of different dose rates plain for all to appreciate. Illustration 2, copied on page 227 with a more quantitative caption, shows monthly radiation dose rates as the areas of circles. The largest is the red circle describing the dose rate which is fatal to tumour cells given at 2,000 mGy in each daily treatment; the yellow circle at 1,000 mGy daily is the peripheral dose that carries a 5% risk of causing further cancer, as described in Chapter 8. There is no evidence for any life-threatening damage from an acute dose of 100 mGy and, as the clinical experience of radiotherapy has shown, a dose divided into daily doses spread over a month is substantially less harmful than a single acute dose. It follows that a chronic dose rate of 100 mGy per month should be even less harmful than the acute 100 mGy threshold found for survivors of Hiroshima and Nagasaki. So we show this monthly rate, the AHARS chronic dose rate safety threshold level as the green circle in Illustration 2. Also shown, in sharp contrast, is the ALARA safe dose rate limit recommended by ICRP, 1 mGy per year [10] – the area of the tiny black dot within the green circle. This is so small that it has also been drawn in a magnified view. The AHARS dose rate is 1,000 times larger than the ALARA value but comparable with the safety threshold set in 1934. This factor of a thousand is a measure of the extent to which ALARA exaggerates risk. Neglect of this factor is responsible for the socio-economic damage of recent nuclear accidents. Only a couple of weeks was needed to make an initial assessment of radiation exposures at Fukushima on this scale [SR8]. With an AHARS safety level, all the evacuated residents from the Fukushima region might then have returned to their homes to resume productive lives. Similarly power plants in Japan might then have restarted, and the rest of the world should then have returned to business as usual. Actually the first did not restart until 11 August 2015, still accompanied by protests. In due course the wreckage of the three damaged reactors has to be cleaned up properly but there is no reason why that should stop activity in the rest of the world.


Largest lifelong dose that is safeBut is this too hasty? Is there a limit to the total dose that living tissue can withstand in a lifetime? Even if we do not know if that is really necessary, we should use data to put a limit on it. As the years go by, this should be raised as further data and greater biological understanding become available. Certainly chromosome abnormalities accumulate, but it is the health of the immune system that is crucial. Anyway we should let mortality data answer the question. What figure do presently available data suggest? We saw in Chapter 6 that the threshold lifetime dose for cancer among the Radium Dial Painters is 10,000 mGy, a whole-body dose delivered chronically by the radium in their bones, although this alpha radiation is considered 20 times more damaging per Gy than beta or gamma radiation. So 10,000 mGy should be an underestimate of the lifetime tolerance for beta and gamma by a large margin.There are two other estimates that are relevant. There is the threshold for a second cancer seen at about 5,000 mGy, Illustration 33 on page 197, although that dose is received locally in six weeks, not to the whole body in a lifetime. That means that the threshold 5,000 mGy, considered as a whole-of-life figure, could be a significant underestimate.Finally there are the beagle data for a lifelong chronic dose rate of 100 mGy per month that showed no sign of life shortening until the dogs had received a total whole-body dose of between 6,000 and 9,000 mGy, Illustration 32 on page 187. This is the threshold value we are looking for, except that it is measured for dogs rather than humans. Nevertheless there is some consistency between these three sets of data that suggests that 5,000 mGy would be a conservative value for a whole-of-life dose limit – it is as low as any of them. It corresponds to more than four years of receiving the AHARS maximum monthly dose rate of 100 mGy per month.These safety thresholds are particularly cautious because they take no account of the beneficial adaptive effect of low-dose-rate radiation that can stimulate cancer resistance. This important possibility is really a matter for medicine, not safety regulation. But it does mean that in general there may be a dose-rate at which the positive stimulation balances the negative carcinogenesis. This has been called the No Observed Adverse Effects Level (NOAEL). However, it is too simplistic to see this as a single point on a curve. Its movement with the time profile of dose delivery and any subsequent morbidity will be important too.

Origin of currently recommended safety limitsWhere did ALARA, the current ultra-cautious safety guidance, originate? As


we shall see in Chapter 10, it is a product of history and politics, not considerations of science or safety. Its parentage has ensured that it carries the full weight of a UN recommendation that leaves limited choice to national authorities. Only the bravest government would ignore the guidance provided by the ICRP, backed by the IAEA – and this guidance is to keep all radiation doses As Low As Reasonably Achievable. Any government that ignored such advice would risk being pursued by a frightened populace and soon be out of office. Worse, faced with any case brought to a court of law, any authority might wish it had played safe, as the law might see it. However, a court of law is a most inept forum in which to contest science. Education of the populace is a cheaper and more positive way ahead, but that takes time.So, if national authorities are not to blame, it must be the fault of the ICRP who made such recommendations. Well, yes, but the original fault should be laid at the door of all those around the world who from the 1950s to the 1980s and even today, demonstrated, marched, sat in, chanted and voted with a popular voice for a world with minimal radiation. ALARA is the result and it is the fault of everybody who expressed their views so strongly at that time. However, now they should think again – and many have done so. Politicians and those with entrenched views should realise that times have changed and that radiophobia was never based on science in the first place.What should be done now? If we do not want to succumb to the worldwide catastrophes that seem likely to accompany an ever more polluted atmosphere, we must reverse public perceptions of radiation and engage with nuclear energy as soon as possible. That will require a culture of public trust, based on a vigorous but sympathetic educational programme about radiation science. Should that be all so difficult? The public already has a fairly balanced attitude to radiation from the Sun and a degree of confidence about radiation in clinical medicine. Public perceptions can switch much faster than many imagine – just think how quickly attitudes to smoking have turned around, not just in one country, but almost universally. Perceptions of refugees change monthly as the public switch between identifying with their plight and otherwise.New realistic safety regulations should bring major cost savings to any nuclear programme. Cheaper electricity would influence the public view, but first it needs to be offered. While no corners should be cut in respect of the control of reactor stability and its heat output, with justifiable safety standards, large parts of the cost of nuclear power could still be dramatically reduced, whichever flavour of future nuclear technology is chosen. Matters of nuclear waste, reprocessing and decommissioning should take their place lower in the list of priorities alongside other environmental problems requiring responsible and transparent solutions, like the disposal of hazardous chemical and biological waste.


We have survived on planet Earth, more successfully than other animals, through an ability to think rationally. In the past 60 years we have stopped thinking and become scared of the solution to our predicament. We should admit our error and turn about. That means public information, schools programmes, new national regulations, new working practices, new cost estimates. With the reach of television and the skills of people to harness social media to a cause that should be seen as theirs, it ought to be possible to make the change. Some will see this task as impossible, but they should heed the advice seen recently at the foot of an academic email: Those who say it cannot be done should not interrupt those who are doing it.

Conscious thought and adaptationLife is a struggle, sometimes against unseen forces, often against intense competition. To an individual in society, success in life may be expressed in terms of money. Money is but a means of exchange, giving choice and access to the real goals of freedom from fear, access to food, water, warmth and shelter. To the ambitious, what is important may be a position in a virtual pecking order, but for society as a whole, success is marked by a healthy population at peace with itself. Natural calamities, epidemics, internal or external strife, and the effects of over-population endanger this. At a global level money is a means of organising how human effort is distributed and motivated, although it is often not effective at that.If humans planned to live the simple life on earth, there would be no need for further adaptation of life through cognitive ideas. But that is not the case. We no longer have a small population with short lives limited by the natural diseases of ageing. So we need to understand the biology of life sufficiently well to modify it and understand, too, the social implications of the technologies we use and how they relate to health and the environment. These are questions for which evolution has not already prepared us. Everybody needs a more holistic understanding of life and the environment.

Public attitudes towards nuclear technologyIn particular, we need to understand nuclear technology, its impact on health and what it can do for the environment. Even though few people currently understand it, there is no reason why the subject should be seen as more obscure than other branches of science. As a cure for cancer it has been an important part of the ability to extend life for over a century. However, its role in politics and the environment has been seen as destructive and in the interest of no one. The science has been shunned by many and the general population has not been encouraged to find out more. The number and status of the international committees who pronounce on nuclear matters has grown because of official and public ignorance. As both officials and the public become more knowledgeable, as they should, these committees and their


influence should be pruned.The present clash of views over the safety of nuclear technology is remarkable, because there is no real danger – at least none comparable to the dangers of fire or road traffic. Reactors may have been destroyed at Fukushima, but there has been no significant detrimental health effect from radiation. Even at Chernobyl, where the reactor was utterly destroyed, there were only 42 known deaths actually caused by radiation. Radiation deaths from nuclear accidents are zero or few, except for theoretical phantoms based on paper calculations with LNT. So it would seem that, while the fire antis of long ago had good grounds for safety concern, the nuclear antis of today have none for low or moderate doses.

What about radioactive waste and nuclear terrorist threats? Public misinformation and panic apart, these are only dangerous to the extent that radiation is dangerous. If the dangers of radiation have been overestimated, then waste is less of a problem, and nuclear terrorism too. Up to now the public have viewed nuclear waste and the threat of terrorism as unbounded horrors. This is not justified by science – it is mistaken. Public fear and panic is a quite different problem that needs a quite different targeted solution. Nuclear waste, though nasty stuff, does not spread or infect like fire or the disease encouraged by biological waste. Because nuclear energy is so concentrated, little fuel is used and little waste is created – about a millionth as much as for fossil fuel. The waste needs to be cooled, reprocessed (to retain the valuable unused fuel) and the remainder buried after a few years – no bigger a task than handling many chemical waste products whose toxicity persists indefinitely. The effort and expenditure lavished on nuclear waste and plant decommissioning should be reduced; the cost saving should be substantial though vested interests would have their own reasons to argue against that.

If we follow the urgings of the anti-nuclear advocates, our prospects on planet Earth will be no better than animals, a massive reduction in numbers with a low standard of living. So we should study and apply knowledge, as our forbears did with fire. Though they were faced with a finely balanced dilemma, they did a better job at decision-making than we have done recently. Generally, those in authority have little understanding of science, although new prosperity depends on scientific innovation, as it has in the past.

Great rewards will be reaped by the countries that first set aside the legacy of the LNT model and embrace cost effective nuclear technology with sensible safeguards. As well as electric power, this technology can provide large quantities of fresh water by desalination, harmless and cheap food preservation by irradiation without refrigeration, and further advantages in


medical care. The world needs these opportunities to expand economically and socially, but the philosophy of ALARA and LNT stands in the way. The great eighteenth century economist, Adam Smith, said:

Science is the great antidote to the poison of enthusiasm and superstition.

He saw clearly that unless excessive activity caused by enthusiasm or the suppression of activity caused by superstition is properly rooted in science, its effect is poisonous. As we have seen fear of nuclear energy is a superstition without scientific foundation that should be exposed for what it is – or its demons exorcised, as the mediaeval church might have expressed it.

Notes on Chapter 9

1) Notes from My White House Education Lanny J Davis (2002) http://www.amazon.com/Truth-To-Tell-Yourself-Education/dp/0743247825

2) What Becomes of Nuclear Risk Assessment in Light of Radiation Hormesis JM Cuttler (2007) http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2477701/

3) Mortality and Cancer Incidence ... in the National Registry of Radiation Workers Muirhead CR et al, British Journal of Cancer 100, 206 (2009)

4) Dose-effect relationships and...Tubiana, M. and Aurengo, A. Académie des Sciences & Académie Nationale de Médecine. (2005) http://www.researchgate.net/publication/277289357_Acadmie_des_Sciences_Academy_of_Sciences-_Acadmie_nationale_de_Mdecine_National_Academy_of_Medicine

5) Some nonscientific influences on radiation protection standards and practice. Taylor LS The Sievert Lecture 1980. Health Physics 39: 851-874

6) Environmental and other academic support for German nuclear power (2014) http://maxatomstrom.de/umweltschuetzer-und-wissenschaftler/

7) How can organisations learn faster? Schein EH, MIT Sloan School of Management http://dspace.mit.edu/bitstream/handle/1721.1/2399/SWP-3409-45882883.pdf?sequence=1

8) The Voyage of the Beagle Charles Darwin, http://www.boneandstone.com/articles_classics/voyage_of_beagle.pdf

9) These data are discussed and tabulated in more detail, including references, in Chapter 6 Radiation and Reason [SR3]

10) Report 103: Recommendations International Commission for Radiological Protection. ICRP 2007 http://www.icrp.org

http://www.amazon.com/Truth-To-Tell-Yourself-Education/dp/0743247825

http://www.icrp.org/

http://www.boneandstone.com/articles_classics/voyage_of_beagle.pdf

http://dspace.mit.edu/bitstream/handle/1721.1/2399/SWP-3409-45882883.pdf?sequence=1





http://maxatomstrom.de/umweltschuetzer-und-wissenschaftler/

http://www.researchgate.net/publication/277289357_Acadmie_des_Sciences_Academy_of_Sciences-_Acadmie_nationale_de_Mdecine_National_Academy_of_Medicine



http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2477701/

Chapter 9: Society, Trust and Safety

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Transcript of Chapter 9: Society, Trust and Safety